Individual provider Active NPI

Mark Allen Dameron

  • Student in an Organized Health Care Education/Training Program
  • San Francisco, CA
National Provider Identifier
1962381855
Registry record updated Aug 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1500 Franklin St
San Francisco, CA 94109-4523
Phone
(415) 474-7310
NPI assigned
Aug 27, 2025
Sex
Unspecified or another gender identity
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1500 Franklin St
San Francisco, CA 94109-4523

Mailing address

785 Brannan St Apt 208
San Francisco, CA 94103-6239
Phone (415) 806-0338

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1756252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756252800000",
    "number": "1962381855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "785 BRANNAN ST APT 208",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941036239",
            "telephone_number": "415-806-0338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 FRANKLIN ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941094523",
            "telephone_number": "415-474-7310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMERON",
        "first_name": "MARK",
        "middle_name": "ALLEN",
        "sole_proprietor": "YES",
        "sex": "X",
        "enumeration_date": "2025-08-27",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.